A Simonaggio1, R Elaidi1, L Fournier2, E Fabre3,4, V Ferrari5, D Borchiellini5, J Thouvenin6, P Barthelemy6, C Thibault1, E Tartour7,4, S Oudard1, Y A Vano8,9. 1. Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France. 2. Department of Radiology, Hôpital Européen Georges Pompidou, Paris, France. 3. Medical Thoracic Oncology Department, Hopital Européen Georges Pompidou, Paris, France. 4. U970, Université Paris Descartes Sorbonne Paris-Cité, 75006, Paris, France. 5. Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 6. Department of Medical Oncology, University Hospital of Strasbourg, Strasbourg, France. 7. Department of Immunology, Hôpital Européen Georges Pompidou, 75015, Paris, France. 8. Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France. yann.vano@aphp.fr. 9. INSERM, UMR-S 1138, Centre de Recherche des Cordeliers, Team "Cancer, Immune Control and Escape", University Paris Descartes Sorbonne, 75006, Paris, France. yann.vano@aphp.fr.
Abstract
BACKGROUND: An elevated pre-treatment neutrophil to lymphocytes ratio (NLR) is associated with poor prognosis in various malignancies. Optimal cut-off is highly variable across studies and could not be determined individually for a patient to inform his prognosis. We hypothesize that NLR variations could be more useful than baseline NLR to predict progression-free survival (PFS) and overall survival (OS) in patients (pts) receiving anti-PD1 treatment. PATIENTS AND METHODS: All pts with metastatic renal cell carcinoma (mRCC) and metastatic non-small cell lung cancer (mNSCLC) who received anti-PD1 nivolumab monotherapy in second-line setting or later were included in this French multicentric retrospective study. NLR values were prospectively collected prior to each nivolumab administration. Clinical characteristics were recorded. Associations between baseline NLR, NLR variations and survival outcomes were determined using Kaplan-Meier's method and multivariable Cox regression models. RESULTS: 161 pts (86 mRCC and 75 mNSCLC) were included with a median follow-up of 18 months. On the whole cohort, any NLR increase at week 6 was significantly associated with worse outcomes compared to NLR decrease, with a median PFS of 11 months vs 3.7 months (p < 0.0001), and a median OS of 28.5 months vs. 18 months (p = 0.013), respectively. In multivariate analysis, NLR increase was significantly associated with worse PFS (HR 2.2; p = 6.10-5) and OS (HR 2.1; p = 0.005). Consistent results were observed in each cohort when analyzed separately. CONCLUSION: Any NLR increase at week 6 was associated with worse PFS and OS outcomes. NLR variation is an inexpensive and dynamic marker easily obtained to monitor anti-PD1 efficacy.
BACKGROUND: An elevated pre-treatment neutrophil to lymphocytes ratio (NLR) is associated with poor prognosis in various malignancies. Optimal cut-off is highly variable across studies and could not be determined individually for a patient to inform his prognosis. We hypothesize that NLR variations could be more useful than baseline NLR to predict progression-free survival (PFS) and overall survival (OS) in patients (pts) receiving anti-PD1 treatment. PATIENTS AND METHODS: All pts with metastatic renal cell carcinoma (mRCC) and metastatic non-small cell lung cancer (mNSCLC) who received anti-PD1 nivolumab monotherapy in second-line setting or later were included in this French multicentric retrospective study. NLR values were prospectively collected prior to each nivolumab administration. Clinical characteristics were recorded. Associations between baseline NLR, NLR variations and survival outcomes were determined using Kaplan-Meier's method and multivariable Cox regression models. RESULTS: 161 pts (86 mRCC and 75 mNSCLC) were included with a median follow-up of 18 months. On the whole cohort, any NLR increase at week 6 was significantly associated with worse outcomes compared to NLR decrease, with a median PFS of 11 months vs 3.7 months (p < 0.0001), and a median OS of 28.5 months vs. 18 months (p = 0.013), respectively. In multivariate analysis, NLR increase was significantly associated with worse PFS (HR 2.2; p = 6.10-5) and OS (HR 2.1; p = 0.005). Consistent results were observed in each cohort when analyzed separately. CONCLUSION: Any NLR increase at week 6 was associated with worse PFS and OS outcomes. NLR variation is an inexpensive and dynamic marker easily obtained to monitor anti-PD1 efficacy.
Entities:
Keywords:
Anti-PD1; NLR variation; Neutrophil to lymphocyte ratio (NLR); Nivolumab; Non-small cell lung cancer; Renal cell carcinoma
Authors: Mehmet A Bilen; Brian I Rini; Martin H Voss; James Larkin; John B A G Haanen; Laurence Albiges; Lance C Pagliaro; Eric G Voog; Elaine T Lam; Nikolay Kislov; Bradley A McGregor; Aly-Khan A Lalani; Bo Huang; Alessandra di Pietro; Stan Krulewicz; Paul B Robbins; Toni K Choueiri Journal: Clin Cancer Res Date: 2022-02-15 Impact factor: 13.801
Authors: Sara Elena Rebuzzi; Alessio Signori; Giuseppe Luigi Banna; Marco Maruzzo; Ugo De Giorgi; Paolo Pedrazzoli; Andrea Sbrana; Paolo Andrea Zucali; Cristina Masini; Emanuele Naglieri; Giuseppe Procopio; Sara Merler; Laura Tomasello; Lucia Fratino; Cinzia Baldessari; Riccardo Ricotta; Stefano Panni; Veronica Mollica; Maria Sorarù; Matteo Santoni; Alessio Cortellini; Veronica Prati; Hector Josè Soto Parra; Marco Stellato; Francesco Atzori; Sandro Pignata; Carlo Messina; Marco Messina; Franco Morelli; Giuseppe Prati; Franco Nolè; Francesca Vignani; Alessia Cavo; Giandomenico Roviello; Francesco Pierantoni; Chiara Casadei; Melissa Bersanelli; Silvia Chiellino; Federico Paolieri; Matteo Perrino; Matteo Brunelli; Roberto Iacovelli; Camillo Porta; Sebastiano Buti; Giuseppe Fornarini Journal: Ther Adv Med Oncol Date: 2021-05-18 Impact factor: 8.168